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J Med Toxicol. 2014 Jun;10(2):210-4. doi: 10.1007/s13181-013-0353-4.

Prolonged use of intravenous lipid emulsion in a severe tricyclic antidepressant overdose.

Author information

1
Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA, ragarwal@wakehealth.edu.

Abstract

INTRODUCTION:

Intravenous lipid emulsion (ILE) resuscitation is now frequently being used for severe overdoses due to lipophilic drugs. However, the optimal dose, duration, and safety are still unclear.

CASE REPORT:

A patient with refractory cardiovascular collapse following an amitriptyline overdose was treated with ILE with initial improvement. Instability recurred after ILE discontinuation and lipid therapy was restarted, but high-dose treatment was complicated by severe lipemia. A low-dose infusion was instead used, and the patient did not experience further toxicity despite amitriptyline levels in the toxic range for 21 days. He survived to discharge without long-term sequelae.

DISCUSSION:

A low-dose infusion of ILE was well tolerated and may have successfully prevented recurrent toxicity in a case of severe tricyclic antidepressant overdose.

PMID:
24173885
PMCID:
PMC4057528
DOI:
10.1007/s13181-013-0353-4
[Indexed for MEDLINE]
Free PMC Article
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